空腹血糖受损与糖耐量受损患者血管内皮功能的对比研究

目的:应用多普勒超声技术检测空腹血糖受损(IFG)与糖耐量受损(IGT)患者的血管内皮功能,探讨其对动脉粥样硬化的影响。方法:根据口服葡萄糖耐量试验(OGTT)结果,选择血糖正常(NGT)组25例,IFG组24例,IGT组22例,检测TC、TG、LDL-C、HDL-C、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1C)、高敏C反应蛋白(hs-CRP)及血管性血友病因子(vWF),OGTT后2h血糖(2hPG)及2h胰岛素(2hINS),以及肱动脉内皮依赖性舒张功能(EDD)。结果:IGT组vWF较IFG组、NGT组明显升高[(170.25±21.76)%∶(155.16±17.19)%、(135.46±15.52)%,P<0.05～0.01],肱动脉EDD较IFG组、NGT组明显降低[(4.86±0.94)%∶(5.47±0.90)%、(6.24±0.97)%,P<0.05～0.01];IFG组vWF较NGT组明显升高[(155.16±17.19)%∶(135.46±15.52)%,P<0.05],肱动脉EDD较NGT组明显降低[(5.47±0.90)%∶(6.24±0.97)%,P<0.05]。多因素逐步回归分析显示,EDD与2hPG、LDL-C明显负相关(r分别为-0.73、-0.59,P<0.05)。结论:IGT较IFG对血管内皮功能危害更大,加强IGT防治对延缓动脉粥样硬化更为重要。

Comparison of the vascular endothelial function between peoples with impaired fasting glycemia and impaired glucose tolerance

Objective:To observe vascular endothelial function with high-resolution Doppler ultrasonography between peoples with isolated impaired fasting glycemia and isolated impaired glucose tolerance,and study its influence on atherosclerosis. Method:According to the OGTT result,randomly choose 25 cases of normal glucose tolerance as NGT group,24 cases of impaired fasting glycemia as IFG group,and 22 cases of impaired glucose tolerance as IGT group.TC,TG,LDL-C,HDL-C,FPG,FINS,HbA1C,hsCRP and vWF were detected after overnight fast,and 2 h PG and 2 h INS were detected after 2 hours of OGTT.Ultrasound evaluation of their brachial arteries endothelium-dependent dilation(EDD) was conducted. Result:vWF in IGT group was higher than that in IFG group or NGT group [(170.25±21.76)% vs(155.16±17.19)%,(135.46±15.52)%,P<0.05~0.01].Brachial artery EDD in IGT group was significantly lower than that in IFG group or NGT group [(4.86±0.94)% vs(5.47±0.90)%,(6.24±0.97)%,P<0.05~0.01].vWF in IFG group was higher than that in NGT group [(155.16±17.19)% vs(135.46±15.52)%,P<0.05].Brachial artery EDD in IFG group was significantly lower than that in NGT group [(5.47±0.90)% vs(6.24±0.97)%,P<0.05].Stepwise regression analysis showed that EDD was negatively related to 2 h PG and LDL-C(r=-0.73,-0.59,P<0.05). Conclusion:Vascular endothelial function is damaged more severely in IGT group than in IFG group.It is very important to prevent and cure IGT for delaying atherosclerosis.